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Thursday, April 17, 2014
Diet and Nutrition
Losing Over 100 Lbs.
I used to be more (much more) than 100 lbs overweight. 2 years ago I decided "This is It." and I went on a serious diet. Lost about 50 lbs (the "right" way, ie, slowly, over about 40 weeks, by going to a low fat, calorie controlled diet and by gradually increasing my exercise). Then I got "stuck" there. I suppose I should be glad I didn't gain it back over the last year or so, but I haven't lost any more since then either. My BMI is still about 32, so I am still clinically obese, and my health risks are just as bad as they ever were.
Meanwhile, I've read everything I can get my hands on about weight management, and the problem is, for every piece of advice (or research) that says one thing, there's another piece of advice (or research) that says exactly the opposite. Even measures that the "mainstream" used to consider to be Kooky or Whacky or Radical are now becoming very mainstream recommendations. But they weren't always. So how do I know that the *current* "mainstream" recommendations aren't as much "behind the times" as they were back when (eg) they used to call lo fat vegetarian diets "Fad" or "Kook" diets, and when VLCD "medically supervised" near-starvation programs were considered "mainstream" and complaints by the obese that "starvation dieting slowed down our metabolism & made us feel sluggish" were dismissed as being "whiney excuses" and "Not True." (now they are considered True) I've been struggling with my weight for long enough to have seen even the MAINSTREAM experts to an About Face on just about every conceivable issue at one time or another (I remember when we were told that it was carbohydrates that made us fat, and if we "cut out carbohydrates" we would not be obese -- NOW that is considered a "Radical" approach, but I remember when it was my own conservative family doctor's recommendation!) I've even read a fairly convincing article that claimed that dieting is the CAUSE of obesity.
I am so confused on what to do, it seems like no matter WHAT I do, there will be somebody or some article or some research somewhere that will be "warning" me that I'm going about it ALL wrong, and citing 2 Bazillion Studies &tc that "Prove" that I'm doing it ALL wrong and risking my health. This is so FRUSTRATING! I think one of the reasons I'm not losing any more weight is that I can never stick to any ONE program or plan for very long, and part of the reason for that is because almost as soon as I get started, I read or hear something that "warns" that the very plan I'm attempting to follow "has been shown" to Not Work, or to have Bad Consequences years later, or SOMETHING.
The plan I lost the first 50 lbs on was very simple: 2x as many grams of carbohydrates as protein, no more than 20% of total calories from fat, and just keep adjusting the exact numbers (but keep the ratios the same) as necessary in order to keep losing about a lb per week.
But now I'm almost afraid to follow that, as I've heard & read all kinds of claims about how "wrong" that kind of a diet is. Besides that, by the time I'd lost 50 lbs I was down to about 900 calories/day and still not losing any more weight, and not only was it HARD to keep eating that little food, but I also have heard & read that it is dangerous to eat less than 1200 calories/day for an extended period.
Since then I started exercising, and now with about an hour/day of walking I am actually UP to being able to eat 1200 calories/day without Gaining. But I'm sure not Losing either. And my BMI is still over 32, so I still obviously need to lose More. HELP!
How do I sort this all out?!?!?!?
PS I apologize that this is so Long.
Congratulations on losing 50 lbs. the "right way" and maintaining that weight loss. With so many weight loss methods to choose from, doing it the "right way" is no easy task. The questions you have asked are shared by many; so are the frustrations.
First, you asked how to know whether or not diet information can be trusted or believed. Keep in mind that the science of nutrition is relatively new (compared to a science such as astronomy or geology) and it is constantly evolving. Scientists continually challenge and revise their "facts" as new information is uncovered (and proven to be scientifically valid by duplicating the studies). Sometimes the media reports these new findings before tests are completed and confirmed. It may be a "big scoop" for them, but results in confusion and distrust of nutrition scientists by the general population. The best advice I can give you is to take the information you read or hear and critically evaluate it. Learn all you can about the diet advice before taking action. When new diet information comes on the market, be cautious. "Red flags" to signal trouble include: (1) promise of quick, dramatic weight loss, (2) easy to do, (3)costly, (4) severely limits or restricts food choices, (5) restricts or eliminates 1 or more major nutrients or food groups, (6) is inadequate in vitamins and minerals, (7) does not include exercise, (8) cites testimonials, (9) doesn't recommend variety and moderation, and (10) is only to be used for a set period of time. This will help safeguard you from misinformation and possible harm.
Your second question involved two parts: (1) why you are not losing any more weight and (2) why can't you stick to any ONE program for very long? In the first part of your question, you are describing a plateau. This may result from any of the factors that contribute to obesity (genetic, metabolic, biochemical, psychological, and physiological), the effect of yo-yo dieting, societal influences, overabundance of food choices, or the many other factors still being explored. For example, a plateau may occur because you are building muscle (by exercising) which is heavier than the fat you are losing. The scale does not tell the entire story and the numbers on it are "arbitrary" in thoroughly describing the positive effects your lifestyle changes are making. Another possibility is that if you are limiting your calories so severely (less than 1200 per day), your body interprets this as a state of starvation and actually slows down your metabolism to conserve nutrients and energy (thus slowing down your weight loss).
The second part of your question involves how to follow a program and which ONE. All diets "work" temporarily, but none have been proven to work long term (if one did, the other diets would disappear from the market forever!). The goal of any GOOD diet is to lose body fat, preserve and/or increase muscle tone, and change your poor eating and exercise habits to good ones that you can live with for a lifetime. Therefore, you do not go "on a diet" (so that you can go off one). Instead, you adopt a new value system and focus on a better lifestyle. This helps avoid the feelings of disappointment, frustration, etc. from lapse and relapses. In other words, the emphasis is not to follow a specific diet, but to follow the "nondiet approach" which focuses on wellness rather than weight loss.
According to the Healthy Weight Journal publication "Health Risks of Weight Loss," most treatment programs that use the nondiet approach focus on three factors: feeling good about oneself, eating well in a natural, relaxed way, and being comfortably active. The nondiet advocates helping people learn hunger awareness, how to respond to internal signals, self-discovery (not willpower), self esteem, diversity and accepting people as they are (not judging), and getting on with one's life, not waiting to be thin. In the book "You Count, Calories Don't" by Linda Omichinski, RD, key differences between diet and nondiet thinking are described. For example: a dieter's goal is weight loss, a nondieter's goal is to develop confidence in his/her ability to make choices for better health.
For more information on the nondiet, you may enjoy reading Omichinski's book or "Intuitive Eating" by Evelyn Tribole, MS, RD and Elyse Resch, MS, RD. A Registered Dietitian can help too. To find a Dietitian in your area, try the American Dietetic Association's Nationwide Nutrition Network at the link listed below.
I hope this has helped put things into perspective and alleviates your frustration. Have a happy and healthy New Year!
Jane Korsberg, MS, RD, LD
Senior Instructor of Nutrition
School of Medicine
Case Western Reserve University